COMMUNITY
SCREENING, RISK FACTORS AND IMPACT OF CHILDHOOD DISABILITIES
Hemidah SA1,
Sami SM1, Salama II1, El Rafie M2, El
Sherbini E2
1 National
Research Center, Cairo, Egypt
2 Faculty of
Medicine, Cairo University, Cairo, Egypt
Objective: To assess the
prevalence of and to identify the risk factors associated with childhood
disability in a low socioeconomic area of Cairo governorate.
Methods: One thousand children
aged 2-12 years were screened using the Ten Point Questionnaire (TPQ) to
pick up the suspected disabilities. Children screened positive
were medically assessed by specific
diagnostic tests. Data were statistically analyzed using univariate and
multivariate analysis
Results: The prevalence of
disabilities was found to be 9.2%. The most common disabilities were
hearing (43.5%), mental (24.3%) and visual (17.4%) disabilities. Hearing
and mental disabilities were found to be significantly (P<0.01) higher
among low birth weight children. Parental consanguinity (P<0.01),
maternal education (P<0.01) and maternal working (P<0.05) were the
relevant social risk factors for childhood disabilities. Significant
antenatal risk factors were hypertension and bleeding during pregnancy
while the child related risk factors comprised neonatal troubles, major childhood
accidents and uncompleted obligatory vaccination. Multivariate logistic
analysis showed that consanguinity, maternal education, bleeding during
pregnancy, major accidents and uncompleted obligatory vaccination were the
predictable variables for the presence of disability with adjusted Odds
Ratio (OR) ranged from 5.8-86.3. The significant psychological impacts of
disability were problems in dealing with others (OR 18.6) and nocturnal
enuresis (OR 14.3). Out of school-aged children with disability 5.5%
attended special schools and 3.5% dropped out of ordinary schools.
Conclusion: Ten Point Questionnaire
revealed high positive predictive value, thus they could be recommended for
valid detection of disability on community basis. A good surveillance system
and a comprehensive integrated program are recommended for the welfare o f
disabled children.